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A paradigm shift seems to be taking place gradually in the management of organ, tissue and cell transplantation in Latin America and the Caribbean. In Argentina, a law sanctioned in 2005 and promulgated again with major adjustments on 4 July obliges all citizens over eighteen years of age to appear before certain public authorities to deny that parts of their body were given after their death ; Those who do not formally express their opposition will automatically be considered as voluntary donors when they perish. The regulations in question were approved unanimously in the Chamber of Deputies; only its regulation by the government of Mauricio Macri remains in suspense.
Exactly three months before, the Mexican Senate gave the go-ahead to a reform of the general health law that replaces the explicit consent figure with that of the presumed consent in organ donation issue. If the Chamber of Deputies also gives its approval, it will not be necessary that a person expresses his willingness to donate by means of a card or letter registered with a notary; on the contrary, he will be the one who wants his body to remain intact after his death and who must officially notify him. Uncertainty is always there if the last word will be the couples and relatives of the deceased who, in life, have never spoken openly about the fate that they wanted for their remains.
"Nobody is going to go against the family," said recently Alberto Maceira, president of the Central National Institute Unique Coordinator of Ablation and Implant (INCUCAI) of Argentina. He knows that at the time of writing the details of the new law he will touch to clear the windmills. Many of their compatriots fear losing the right to decide what will be done with the remains of their loved ones; in Argentina, 40% of possible donations are not eaten because of reluctance by family members, says INCUCAI. Others denounce that, as it is planned to organize the transplant system, the means to refuse to give will be narrower and fewer.
Default Donors
"The dependencies of the Federal Police no longer appear as a valid way to express the If it is now presumed that you are donating, there should be more channels to be able to express the negative.If otherwise, there is a captive group that will not have the freedom to Express his opinion, "said lawyer Ursula Bbadet, of the Faculty of Law of the Austral University, in an interview with the Argentine newspaper Clarín . Bbadet refers to citizens living in rural areas, disconnected from the media and the Internet, but it is also worth mentioning specifically those who have a limited level of literacy and education which limits their ability to make a free and informed decision about it.
Suddenly becoming a default donor is something that does not leave Mexicans indifferent either. Several medical guilds have recommended treating the problem tactfully so that the principle of presumed donation is not considered coercion coming from above. Salvador Aburto, director of the National Transplant Center (CENATRA), described the desire to give as "the purest act of love, altruism and generosity towards others"; but, in a country like Mexico, whose murder rate is inversely proportional to its annual rate of homicide and where access to health, security and justice is what distinguishes the poor rich, it is difficult to Aburto hold.
More than one Mexican should ask what criteria prevail, apart from the simple medical, to prioritize one patient over another at the time of a transplant, or how many 29,168 people killed in their country in 2017 they were stripped of life, first, and organs, later. Founded or not, apprehensions of this kind occur more or less in all the countries of the world. Still in Germany, the European country with the smallest number of donors, according to the Eurotransplant Foundation: ten years ago, it had 16 inhabitants per million inhabitants and in 2017 it had only 9, 3. The German transplant system is 0.7 donor below the mark agreed to be considered functional
Fear of organ trafficking
Ten years ago, the German media cited surveys that feared irregular surgical situations – that not everything was done in hospitals to rescue patients identified as voluntary donors or that One of their organs was extracted in Life, for example, was one of the factors that prevented citizens from cooperating with the local transplant system. In 2018, it is unlikely that this suspicion has decreased. Deutsche Welle has contacted INCUCAI President Alberto Maceira to hear his opinion on the fears surrounding the donation of organs in Argentina. According to him, the only trajectory of the institution under his command should dissipate them all.
By his press coordinator, Pablo Rabotnikof, Maceira baderted that in the South American country there was neither theft nor the trafficking of organs for transplantation. "There is not a single denunciation in the legal history of Argentina that alludes to these crimes.It is an urban myth," emphasized Rabotnikof. However, security and development specialist Robert Muggah says the two crimes are a "real problem" that was first observed in Argentina and Mexico in the seventies and eighties. Muggah is co-founder of the Brazilian research center Instituto Igarapé and his Online Observatory on Violence Homicide Monitor
"Cases of false adoptions between Brazil and Italy shed light on this issue in the 1990s and a series cases of illegal purchases in Bolivia, Brazil, Costa Rica, Honduras, Mexico and Peru, which started at the beginning of this century, it seems that this activity is more important than it is The authors are a combination of corrupt health officials, local criminal gangs and international trafficking networks, "Muggah said in an email at the request of Deutsche Welle. The researcher badumes that the most horrible cases reported by the tabloids represent a very small portion of the organ trafficking
A market like the others
Signs like yours have been refuted for years by transplantation experts. One of them, Alicia Elena Pérez Duarte and Noroña, of the Institute of Legal Research of the National Autonomous University of Mexico (UNAM), commented in several interviews that her search for Verifiable cases of theft or trafficking of organs has always been sterile. Several medical surgeons have confirmed the non-viability of these large-scale practices. Muggah is aware that transplants are sophisticated operations that require clean procedures, fast delivery mechanisms, and complex donor-recipient compatibility studies.
But, in the eyes of the Igarapé Institute badyst, this does not discourage those seeking to withdraw it. unlawfully benefits from this market. "The gap between the legal supply of organs and the demand for transplantation is driving the underground market, and the victims are usually the poorest of the poor," warns Muggah. Beatriz Domínguez-Gil, director of the Spanish National Transplantation Organization, said the same thing recently, adding that the 126,670 transplants performed each year internationally only cover ten percent of the needs, according to the Global Transplant Observatory. . The World Health Organization estimates that 10,000 underground transplants are performed each year worldwide.
What can be done to stop this phenomenon? "Getting solid statistics that tell us the size of this illegal business is a real challenge, but that has not prevented lawmakers from some Latin American countries from toughening the penalties against traffickers." organs, "observes Muggah. On 16 April, Costa Rica became the first non-EU country to accede to the Council of Europe Convention against Trafficking in Human Organs (CETS 216), signed in 2015 in Santiago de Compostela. It remains to be seen whether the introduction of the presumed donor principle puts an end to these crimes by significantly increasing the number of organs likely to be transplanted.
Evan Romero-Castillo
Deutsche Welle is the international radio station in Germany and produces independent journalism in 30 languages. Follow us on Facebook | Twitter | YouTube |
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first heart transplant in the world
A medical sensation
South African surgeon Christiaan Barnard performed the world's first heart transplant, thus going into the history of science. The patient was Louis Washkansky, 54 years old. During an operation at the Groote Schuur Hospital in Cape Town, he received the heart of a young woman killed in an accident. 18 days after the procedure, the recipient died of pneumonia.
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The first heart transplant in the world
A well-trained team
The transplant lasted five hours. There were 31 doctors involved, including Christiaan Barnard's brother. The donor was Denise Ann Darvall, 25, who was diagnosed with brain death. The consent for the extraction of his heart was given by his father.
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The first heart transplant in the world
A true series of heart transplants
On January 2, 1968, Barnard performed a heart transplant, to the second time. Philip Blaiberg lived for 18 months with the heart of someone else. It has been followed by about 100 operations worldwide. But often, the patients died of immune rejection generated by the new heart, which caused fatal infections.
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The first heart transplant in the world
Thanks to the dogs …
Barnard's critics have claimed that The surgical technique had been copied from colleagues in the United States, where he attended hundreds of interventions on dogs. The fact that the then 45-year-old doctor performed such an intervention on a human being has been the subject of severe criticism, particularly by his American colleagues.
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The first heart transplant in the world
Famous night …
The most famous surgeon in the world was born on November 8 1922 in Beaufort West, South Africa, and was the son of a Protestant missionary. He was first badistant physician, then generalist and internist in a hospital for infectious diseases, until becoming a surgeon. With the first heart transplant, he became known around the world.
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The first heart transplant in the world
Between Mandela, the Pope and the Countess of Monaco
Barnard appeared on television, participated at round tables, was hosted at receptions and festivals, as well as important personalities of the time, such as Countess Grace Patricia of Monaco, for example. There was also a visit to Pope Paul VI. The mighty of the world were adorned with his presence.
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The first heart transplant in the world
Died in the pool and some tips …
Christiaan Barnard, a pioneer of heart transplantation, died September 2, 2001 at the age of 78 in Cyprus. At first, it was thought that it was a heart attack, but in reality it would have been an asthma attack. After all, the world-renowned heart surgeon had followed the rules: to exercise, daily, one or two glbades of red wine, olive oil and bad
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The first heart transplant in the world
A feeling that is routine today
Barnard has left medicine an important legacy. Although it took several years and many setbacks for heart transplantation to become a safe treatment method. Today, however, it is a breakthrough. In 2016, 297 heart transplants were performed in Germany and 450 new patients were registered. The problem: the organs of the donor are missing.
Author: Gudrun Heise
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